Providence Health & Services RN - Case Manager/Navigator in Kodiak, Alaska
Providence is calling a Case Manager/Registered Nurse (RN) Navigator (Utilization Review , Day Shift, 1.0 FTE) to Providence Kodiak Medical Center in Kodiak, Alaska. We are a community of caregivers delivering every day on our Mission to provide compassionate care that is accessible for all - especially those who are poor and vulnerable.
In this position you will:
Partner with the healthcare team, community resources, liaisons, patient and families to provide timely coordinated admission and discharge planning that is appropriate based on patient needs
Match patients with appropriate internal and external resources to meet their ongoing needs, and facilitates application(s) for programs and referrals for special needs for admission and discharge planning
Assist in management of resources with informational and monitoring tool(s) that support access, confidentiality, and assessment, analysis of care and throughput, intervention, efficiencies, and quality of care.
Performs integrated initial and concurrent review to identify medical necessity and utilization issues
Apply admission, continued stay/transfer, and discharge criteria to each patient’s case
Interface with external review companies and consultants, using advocacy and negotiating skills that address medical necessity and appropriateness of inpatient/outpatient levels of care
Provide case management for complex patients post-discharge for up to 90 days assuring successful reintegration in the community. Effectively utilizes tools that measure, monitor, and manage quality and stewardship of patient care resources. Act as a partner in identifying and achieving timely patient care needs with implementation of the plan of care that is appropriate, resourceful, and valuable
Required qualifications for this position include:
Graduate of an accredited/approved school of Nursing
Associate's Degree in Nursing
Licensed as a Registered Nurse (RN) in the State of Alaska
Basic Life Support (BLS) certification within 90 days of hire
Current Alaska driver’s license with a clean driving record and proof of current vehicle insurance
Compass training to be completed within 1 year from date of hire
3 years of clinical nursing experience
Prior experience with provider requirements for admissions transfers and discharges
Prior experience using Electronic Medical Records (EMR) such as EPIC
Preferred qualifications for this position include:
Case Management certification
1 year of experience as an RN in Utilization Management-review, Case Management and/or Discharge-planning experience
Experience with InterQual criteria, Medicare and Medicaid regulations
Prior experience using Microsoft Office Suite
About Kodiak Island Medical Center
Providence Kodiak Island Medical Center (PKIMC) provides comprehensive health care to residents and visitors of Kodiak Island. This critical access hospital features 25 acute care beds, including four birthing suites, one OB triage room, and two ICU beds. In addition, the Elder House, PKIMC’s long term care facility, has 22 beds.
PKIMC provides an extensive array of inpatient and outpatient services, including emergency department, surgery, laboratory services, maternity, general medicine, physical therapy, occupational therapy, respiratory therapy, sleep studies, specialty clinics, diagnostic imaging services and pharmacy and is staffed by a mix of primary care physicians, surgeons and specialists who provide family practice, internal medicine, obstetrics, radiology and general practice.
For more information regarding Providence Kodiak Island Medical Center, please click on the following link: http://providence-kodiakhealthcare.jobs/
We offer a full comprehensive range of benefits - see our website for details
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence Health & Services is a not-for-profit Catholic network of hospitals, care centers, health plans, physicians, clinics, home health care and services guided by a Mission of caring the Sisters of Providence began over 160 years ago. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Case Management
Req ID: 251295